When 'Abdominal Migraine' Looks Like Acid Refluxby Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional
When we were searching for the source of our daughter’s gastrointestinal (GI) issues it was a completely frustrating process. She had already been diagnosed with acid reflux (AR), but even with proper treatment for AR she was still dealing with stomach pain. After a number of tests she was eventually diagnosed with “function abdominal pain." It is only now that she is 12 years old and dealing with Migraine disease that we can look back and see that she was most likely dealing with Abdominal Migraine (AM), which can be a precursor to classic Migraine attacks.
What is Abdominal Migraine?
Abdominal migraine is a variant of Migraine disease that is most common in children and presents with abdominal pain, lasting one to 72 hours, with no GI cause found. A family history of Migraine is frequently noted in these children. Children may also have nausea, vomiting, pale skin or flushing along with the stomach pain. It is quite common for the pain to be relieved by a nap. Unlike other GI disease, AM is neurological in nature and is treated with the same medications used to treat Migraine disease.
When to talk to your doctor about AM
If your child has acid reflux, stomach pain is not uncommon. However, the pain of acid reflux is usually relieved by medications like acid reducers, H2 blockers or PPI medications. When those medications fail to relieve the abdominal pain, nausea or vomiting, most doctors will do additional testing to rule out other GI causes for the pain. In our case, our daughter had an additional EGD scope, abdominal ultrasound and an upper GI series, but tests may vary depending on your child’s symptoms and previous test results.
If all of these GI tests are normal, children are frequently diagnosed with functional abdominal pain or abdominal pain that cannot be explained by any visible or detectable abnormality. Functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain syndrome and Abdominal Migraine fall under the umbrella of functional abdominal pain.
As many as 15 percent of children diagnosed with functional abdominal pain may actually have Abdominal Migraine. Along with the symptoms of abdominal pain, nausea, vomiting, pale skin, flushing and pain frequently relieved by a nap, Abdominal Migraines differ from other conditions in that there is a complete resolution of symptoms between attacks. This can be hard to determine if your child also has acid reflux, but keeping a symptom journal can help your physician identify patterns and better determine what is going on with your child.
What we failed to do when our daughter was diagnosed with functional abdominal pain was to mention our family history of Migraine disease. In hindsight, knowing she went on to have Migraine attacks, it could have made all the difference in her treatment. I hope that you can learn from our mistakes.
If your child is diagnosed with functional abdominal pain it is extremely important to discuss any family history of Migraine with your child’s physician.
The good news is that there are wonderful medications out there to treat Abdominal Migraine. Abortive medications treat an attack that is occurring and preventative medications can limit the overall number of attacks. Medications prescribed can depend on how frequent the attacks are, other medical problems and the age of the child. You will need to work with a neurologist to find the appropriate medications and to keep an eye out for the signs of Migraine disease in the future.